[Congressional Bills 116th Congress]
[From the U.S. Government Publishing Office]
[S. 3606 Introduced in Senate (IS)]
<DOC>
116th CONGRESS
2d Session
S. 3606
To provide for the establishment of a Health Force and a Resilience
Force to respond to public health emergencies and meet public health
needs.
_______________________________________________________________________
IN THE SENATE OF THE UNITED STATES
May 5, 2020
Mrs. Gillibrand (for herself, Mr. Bennet, Mr. Markey, Mr. Van Hollen,
Mr. Booker, Ms. Duckworth, Mrs. Feinstein, Mr. Reed, Ms. Rosen, Ms.
Smith, Ms. Harris, and Mr. Blumenthal) introduced the following bill;
which was read twice and referred to the Committee on Health,
Education, Labor, and Pensions
_______________________________________________________________________
A BILL
To provide for the establishment of a Health Force and a Resilience
Force to respond to public health emergencies and meet public health
needs.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ``Health Force and Resilience Force
Act of 2020''.
SEC. 2. HEALTH FORCE.
(a) Purpose.--It is the purpose of the Health Force established
under this section to recruit, train, and employ Americans to respond
to the COVID-19 pandemic in their communities, provide capacity for
ongoing and future public health care needs, and build skills for new
workers to enter the public health and health care workforce.
(b) Establishment.--There shall be established within the Centers
for Disease Control and Prevention a Health Force (referred to in this
section as the ``Force'') composed of community members dedicated to
responding to public health emergencies as declared by the Secretary of
Health and Human Services under section 319 of the Public Health
Service Act, including the COVID-19 emergency, and providing increased
capacity to address ongoing and future public health needs.
(c) Organization and Administration.--
(1) In general.--The Centers for Disease Control and
Prevention shall--
(A) award grants, contracts, or enter into
cooperative agreements for the recruitment, hiring,
managing, administration, and organization of the Force
to States, localities, territories, Indian Tribes,
Tribal organizations, urban Indian health
organizations, or health service providers to Tribes
through the Public Health Emergency Preparedness and
Public Health Crisis Response programs implemented
through such Centers; and
(B) provide assistance for expenses incurred by
States, localities, territories, Indian Tribes, Tribal
organizations, urban Indian health organizations, or
health service providers to Tribes prior to the
awarding of a grant, contract, or cooperative agreement
under subparagraph (A) to facilitate the implementation
of the Force, including assistance for planning and
recruitment activities, as provided for in section 424
of the Robert T. Stafford Disaster Relief and Emergency
Assistance Act (42 U.S.C. 5189b).
(2) Duties of the director.--The Director of the Centers
for Disease Control and Prevention (referred to in this section
as the ``Director'') shall--
(A) identify training resource packages to be
utilized by the Force and develop new training resource
packages, as needed, including by--
(i) collaborating with other Federal
agencies, including the Health Resources and
Services Administration; and
(ii) collaborating with Centers for Disease
Control and Prevention implementing partners,
including public health, health care, and
community-based organizational partners, to
identify and develop such training resource
packages; and
(B) carry out any other activities determined
appropriate by the Director to carry out this section.
(d) Service.--
(1) Minimum requirements.--
(A) In general.--The Force shall be composed of
eligible members selected pursuant to guidelines
developed by the Director in consultation with States,
localities, territories, Indian Tribes, Tribal
organizations, urban Indian health organizations, or
health service providers to Tribes funded entities. At
a minimum such guidelines shall ensure that a member of
the Force--
(i) is at least 18 years of age; and
(ii) has a high school diploma or
equivalent or has successfully completed an
employment literacy test.
(B) Other eligible individuals.--
(i) Citizenship or immigration status.--An
individual who is authorized to work in the
United States, including an individual with
Deferred Action for Childhood Arrivals (DACA)
or Temporary Protected Status (TPS) under
section 244 of the Immigration and Nationality
Act (8 U.S.C. 1254a), shall not be disqualified
for appointment under this section as a member
of the Force because of citizenship or
immigration status.
(ii) Bankruptcy.--An individual shall not
be disqualified for appointment under this
section as a member of the Force because of the
bankruptcy or poor credit rating of such
individual determined to be the result of the
coronavirus public health emergency.
(2) Recruitment.--
(A) In general.--The guidelines developed under
paragraph (1) shall provide for Force recruitment
information to be distributed at the national level
through all available channels and partnerships as
practicable. Such guidelines shall also, as
practicable, require that all graduating high school
seniors be made aware of Force employment opportunities
while in their senior year, and every 2 years
thereafter, unless they opt out of receiving
notifications or have joined the Force. As practicable,
Federal and State Departments of Labor shall share
information about Force opportunities with those
individuals applying for or receiving unemployment
benefits.
(B) Recruitment by state, locality, territory,
indian tribes, tribal organizations, urban indian
health organizations, or health service providers to
tribes funded entities.--With respect to the employment
of Force members in States, localities, territories,
Indian Tribes, Tribal organizations, urban Indian
health organizations, or health service providers to
Tribes funded entities, such areas and entities shall
support extensive recruitment efforts for Force
personnel, including efforts to recruit Force members
among focal communities as described in subsection (g),
as well as low-income, minority, and historically
marginalized populations.
(3) Preference.--Preference in the hiring of Force members
shall be given to individuals who are veterans, unemployed or
underemployed, recently furloughed community-based nonprofit,
public health or health care professionals, or from focal
communities as described in subsection (g).
(4) Training.--
(A) Initial training.--
(i) In general.--Not later than 14 days
after the date of enactment of this Act, the
Director shall identify an evidence-informed
training program for Force members in
accordance with this paragraph. Such initial
training program shall focus on building public
health surveillance knowledge and skills,
particularly contact tracing knowledge and
skills, to address training requirements for
Force members to successfully conduct contact
tracing activities under subsection (e)(1).
States, localities, territories, Indian Tribes,
Tribal organizations, urban Indian health
organizations, or health service providers to
Tribes shall determine which Force recruits
will be provided with initial training to meet
State, locality, territory, and Tribal public
health needs.
(ii) Requirements.--The initial training
program under this subparagraph shall--
(I) be adaptable by State,
locality, territorial, Indian Tribe,
Tribal organization, urban Indian
health organization, or health service
providers to Tribes funded entities to
meet local needs;
(II) be implemented as quickly as
possible by either or both of the
Centers for Disease Control and
Prevention and State, locality,
territorial, Indian Tribe, Tribal
organization, urban Indian health
organization, or health service
providers to Tribes funded entities,
based on local needs and abilities;
(III) be distance-based eLearning
that can be accessed with a smartphone,
with the goal of limiting opportunities
for disease transmission while
maximizing knowledge and skills
acquisition and retention among Force
trainees;
(IV) include refresher training at
regular and frequent intervals as
determined appropriate by the Director;
(V) include training components on
personal safety, including staying safe
around animals in home- and community-
based settings, use of personal
protective equipment, and health
privacy and ethics;
(VI) include standardized testing
to measure knowledge and skills
acquisition and retention; and
(VII) use individual results of
such standardized testing to ensure
that only successfully trained
individuals are maintained as Force
members.
(B) Additional training.--Not later than 90 days
after the date of enactment of this Act, the Director
shall identify and, as necessary, develop additional
evidence-informed training resource packages to provide
Force members the knowledge and skills necessary to
conduct the full complement of activities describe in
subsections (e) and (f). States, localities,
territories, Indian Tribes, Tribal organizations, urban
Indian health organizations, or health service
providers to Tribes shall determine which Force members
will be provided with additional training to meet
State, locality, territory, and Tribal public health
needs.
(C) Miscellaneous.--Where determined necessary, the
Director may--
(i) recommend training under this
subparagraph that includes face-to-face
interaction;
(ii) collaborate with public universities,
including nursing, medical, and veterinary
schools, community colleges, or other career
and technical education institutes, community
health centers and other community-based
organizations, federally recognized Minority
Serving Institutions, as well as public health
associations and State and local health
departments, to develop and implement training
under this subparagraph, particularly for
skills that typically have licensure
requirements; and
(iii) develop training and communications
materials in multiple languages.
(D) Timing.--The training provided under
subparagraph (A)(i) shall be designed to be completed
by Force members within 14 days of the start of such
training. The training programs under subparagraph (B)
shall be made available where necessary to ensure that
Force members are fully trained as soon as possible
after commencing such training.
(E) Specialized training.--In organizing the Force
under this section, the Director may elect to establish
divisions of Force members who receive specialized
comprehensive training, including divisions of Force
members who have met State licensure requirements, have
prior relevant experience, or have supervisory skills
or demonstrated aptitude.
(F) Payment during training.--Individuals shall be
paid for each hour spent in training (including
refresher training) under this paragraph at a rate of
not less than $15 per hour (to be increased each year
based on increases in the Consumer Price Index for such
year).
(5) Salary and benefits.--
(A) In general.--Members of the Force shall be paid
directly by State, locality, territorial, Indian Tribe,
Tribal organization, urban Indian health organization,
or health service providers to Tribes funded entities
and sub-partners using funds provided by the Centers
for Disease Control and Prevention under grants,
contracts, or cooperative agreements under this
section. All Force positions shall be salaried with
health and retirement benefits, including paid family
leave. Payment of salaries and benefits shall be in
accordance with the policies of the State or unit of
local government involved and have the approval of the
State or the Centers for Disease Control and
Prevention, as applicable.
(B) Overtime pay.--The entire amount of overtime
costs, including payments related to backfilling
personnel, that are the direct result of time spent on
the design, development and conduct of Force activities
are allowable expenses under this section. Such costs
shall be allowed only to the extent that payment for
such services is in accordance with the policies of the
State or unit of local government involved and have the
approval of the State or the Centers for Disease
Control and Prevention, as applicable. Dual
compensation under this paragraph shall be prohibited.
(6) Placement.--To the extent feasible, as determined by
State, locality, territorial, Indian Tribe, Tribal
organization, urban Indian health organization, or health
service providers to Tribes funded entities, members of the
Force shall be recruited from and serve in their home
communities. Force members may be physically co-located with
local public health, health care, and community-based
organizations, including community health centers, as
determined appropriate by funded entities.
(7) Supervisory structures.--Members of the Force shall
receive ongoing supportive supervision from staff members of
State, locality, territorial, Indian Tribe, Tribal
organization, urban Indian health organization, or health
service providers to Tribes funded entities or their sub-
partners, as described in paragraph (9). Entities funded under
this section may choose the most appropriate supervisory
structure to use based on local needs, and may promote Force
members into supervisory roles. Such supervision may be also be
provided by Disease Intervention Specialists. The Centers for
Disease Control and Prevention shall provide or direct their
implementing partners to provide, technical assistance and
training opportunities to such funded entities to strengthen
supportive supervision skills and practices.
(8) Supplies and equipment.--Members of the Force and their
supervisors shall receive all necessary supplies and equipment,
including personal protective equipment, through State,
locality, territorial, Indian Tribe, Tribal organization, urban
Indian health organization, or health service providers to
Tribes funded entities, which may use funds awarded under
grants, contracts, or cooperative agreements under this section
to pay for such supplies and equipment.
(9) Subawards.--As authorized by the Centers for Disease
Control and Prevention, State, locality, territorial, Indian
Tribe, Tribal organization, urban Indian health organization,
or health service providers to Tribes funded entities may make
subawards to local partners, including community health centers
and other community-based and nonprofit organizations, in order
to facilitate Force member recruitment, management,
supervision, management, and retention as well as to facilitate
Force integration into existing public health, health care, and
community-based services.
(10) Service in public health emergency.--A State,
locality, territory, Indian Tribe, Tribal organization, urban
Indian health organization, or health service providers to
Tribes receiving funding under a grant, contract, or
cooperative agreement this section shall assign one or more
Force members to respond to a public health emergency in the
area served by such entity. Such Force members shall be under
the supervision and management of the State, locality,
territory, Indian Tribe, Tribal organization, urban Indian
health organization, or health service providers to Tribes
involved.
(11) Service post emergency.--A State, locality, territory,
Indian Tribe, Tribal organization, urban Indian health
organization, or health service providers to Tribes may retain
one or more Force members to continue to work in the area
served by the entity after a public health emergency has ended
in order to--
(A) prevent and respond to future public health
emergencies; and
(B) respond to ongoing and future public health and
health care needs.
(12) Limitation.--A Force member may not be assigned for
international deployment on behalf of the Health Force.
(13) Funding.--All costs associated with the service and
functions of Force members under this section, including salary
and employment benefits as well as associated direct and
indirect costs, shall be paid by the Federal Government through
grants, contracts, or cooperative agreements to States,
localities, territories, Indian Tribes, Tribal organizations,
urban Indian health organizations, or health service providers
to Tribes.
(e) Activities To Respond to the COVID-19 Pandemic.--The Force
shall provide for the training and employment of Force personnel to
address the COVID-19 pandemic, including by conducting or assisting
with the following activities, where such activities are aligned with
State licensure requirements:
(1) Conducting COVID-19 related contact tracing.
(2) When available, supporting the administration of
diagnostic, serologic, or other COVID-19 tests.
(3) As appropriate based on State licensing requirements,
supporting the provision of palliative care, including by
providing support to palliative care teams for seriously ill
patients.
(4) When available, supporting the provision of COVID-19
vaccinations, flu vaccinations, and recommended vaccinations
for individuals who have missed vaccinations because of the
pandemic.
(5) Sharing COVID-19 public health messages with community
members, including debunking myths and misperceptions, and
building health literacy.
(6) Providing data collection and entry or other
administrative duties in support of epidemic surveillance and
to meet broader health information system requirements.
(7) Providing community-based and direct-care services,
including food and medical supply delivery.
(8) Providing coordination or case management of public
health and human services needs related to COVID-19.
(9) Carrying out any other activities, including those
described in subsection (f), as determined appropriate by the
Director.
(10) Carrying out any other activities, including those
described in subsection (f), as determined appropriate by
State, locality, territory, Indian Tribe, Tribal organization,
urban Indian health organization, or health service providers
to Tribes funding recipients, in accordance with grant,
contract, and cooperative agreement scope and stipulations.
(f) Activities Post-Emergency.--After the COVID-19 emergency
concludes, the Force shall provide for the training and employment of
Force personnel to prevent and respond to future public health
emergencies and respond to ongoing and future public health and health
care needs. Under this subsection, Force members shall carry out or
assist with activities described in subsection (e) as well as any of
the following activities, where aligned with State licensure
requirements:
(1) Sharing public health messages with community members.
(2) Providing home-based check-ins for new mothers and
infants.
(3) Providing vaccination schedule reminders, especially
for parents and legal guardians of children under the age of 6.
(4) Providing services to help community members navigate
medical, behavioral health, well health, and social services.
(5) Connecting community members with health and social
services, including services provided by the Federal or State
Governments and community-based organizations.
(6) Providing or supportive provision of additional
perinatal health services, such as serving as doulas, peer
supporters, certified lactation consultants, and home visitors.
(7) Providing community-based information to local health
departments to inform and improve health programming for hard-
to-reach communities.
(8) Preventing the spread of sexually transmitted disease,
including through contact tracing.
(9) Supporting the provision of mental and behavioral
health services, including mental health first aid and peer-to-
peer support.
(10) Other activities determined appropriate by the
Director.
(11) Other activities, including response to localized
public health emergencies, as determined appropriate by State,
locality, territory, Indian Tribe, Tribal organization, urban
Indian health organization, or health service providers to
Tribes funding recipients and in accordance with grant and
cooperative agreement scope and stipulations.
(g) Focal Communities.--State, locality, territorial, Indian Tribe,
Tribal organization, urban Indian health organization, or health
service providers to Tribes funded entities shall dedicate a
substantial number of Force members to addressing the needs of focal
communities. To be designated as a focal community, a community shall
at a minimum--
(1) be in the bottom 50 percent of the United States in
terms of life expectancy, infant mortality, poverty, or other
measure, as recommended by the National Academies of Sciences,
Engineering, and Medicine and approved by the Director; or
(2) be identified as a ``most vulnerable'' community
according to the Centers for Disease Control and Prevention's
Social Vulnerability Index.
(h) Coordination and Collaboration.--
(1) Facilitation.--
(A) In general.--The Director shall facilitate
coordination and collaboration between the Force and
other national public health service programs within
and external to the Department of Health and Human
Services, including the Public Health Service and
Medical Reserve Corps.
(B) Advisory group.--Not later than 6 months after
the date of enactment of this Act, the Director shall
convene a stakeholder advisory group comprised of the
leadership of other national health service programs,
other relevant Federal agencies, including the
Department of Labor and the Centers for Medicare &
Medicaid Services, and leaders representing State,
locality, territorial, Indian Tribe, Tribal
organization, urban Indian health organization, or
health service providers to Tribes funded entities.
Such advisory group shall meet on a yearly basis to
provide guidance for the programmatic success and
longevity of the Force.
(2) States, localities, territories, indian tribes, tribal
organizations, urban indian health organizations, or health
service providers to tribes collaboration.--
(A) In general.--States, localities, territories,
Indian Tribes, Tribal organizations, urban Indian
health organizations, or health service providers to
tribes shall ensure coordination and, as appropriate,
collaboration between the Force and local public
health, and health care, and community-based programs,
to ensure complementarity and further strengthen the
local public health response.
(B) Advisory group.--Not later than 3 months after
the date of enactment of this Act, an entity that
receives a grant, contract, or cooperative agreement
under this section shall convene a stakeholder advisory
group comprised of community leaders and other key
stakeholders to meet on a regular, recurring basis to
provide guidance for the programmatic success and
longevity of the Force.
(C) State compacts.--In accordance with section 115
of the Housing and Community Development Act of 1974
(42 U.S.C. 5315), two or more States to enter into
agreements or compacts, for cooperative effort and
mutual assistance in support of community development
planning and programs carried out under this section as
such programs pertain to interstate areas and to
localities within such States, and to establish such
agencies, joint or otherwise, as such States determine
appropriate for making such agreements and compacts
effective.
(i) Monitoring.--The Director shall develop a performance
monitoring template for State, locality, territorial, Indian Tribe,
Tribal organization, urban Indian health organization, or health
service providers to Tribes funded entities adaptation and use under
this section. Such template shall at a minimum require the reporting of
the number of Force members hired, the role hired into, and the
demographic characteristics of Force members. Such data shall be shared
by entities receiving grants, contracts, or cooperative agreements
under this section to the Centers for Disease Control and Prevention on
a regular, recurring basis. Such data shall be made publicly available.
(j) Learning and Adaptation.--The Director shall develop a learning
and evaluation component of the Force to identify successful components
of local activities conducted under this section that may be
replicated, to identify opportunities for continuing education and
career advancement for Force members, and to evaluate the degree to
which the Force created a pathway to longer-term public health and
health care careers among Force members, and to identify how the Force
impacted the health knowledge, behaviors, and outcomes of the community
members served. Results of this learning shall be made publicly
available.
(k) Reporting.--Not later than 180 days after the end of each
fiscal year, the Director shall submit to the Congress a report which
shall contain--
(1) a description of the progress made in accomplishing the
objectives of Force under this section;
(2) a summary of the use of funds under this section during
the preceding fiscal year;
(3) a list of each recipient of a grant, contract, or
cooperative agreement under this section and the amount of such
grant, contract, or cooperative agreement, as well as a brief
summary of the projects funded by each such recipient, the
extent of financial participation by other public or private
entities, and the impact on employment and economic activity of
such projects during the previous fiscal year; and
(4) a description of the activities carried out under this
section.
(l) Authorization of Appropriations.--
(1) In general.--There is authorized to be appropriated,
and there is appropriated, to carry out this section,
$55,000,000,000 for each of fiscal years 2020 and 2021, such
amounts to remain available until expended.
(2) Emergency.--The amounts appropriated under paragraph
(1) are designated as an emergency requirement pursuant to
section 4(g) of the Statutory Pay-As-You-Go Act of 2010 (2
U.S.C. 933(g)).
(3) Designation in senate.--In the Senate, this section is
designated as an emergency requirement pursuant to section
4112(a) of H. Con. Res. 71 (115th Congress), the concurrent
resolution on the budget for fiscal year 2018.
SEC. 3. RESILIENCE FORCE.
(a) In General.--For the period of fiscal years 2020 through 2022,
the Administrator of the Federal Emergency Management Agency shall
appoint, administer, and expedite the training of a 62,000 Cadre of On-
Call Response/Recovery Employees, under the Response and Recover
Directorate (referred to in this section as a ``CORE employee'') under
the Office of Response and Recovery, above the level of such employees
in fiscal year 2019, to address the coronavirus public health emergency
and other disasters and public emergencies.
(b) Detail of Core Employees.--A CORE employee may be detailed,
through mutual agreement, to any Federal agency that is a participating
agency in the White House Coronavirus Task Force, or to a State, Local,
or Tribal Government to fulfill an assignment for the Task force,
including--
(1) providing logistical support for the supply chain of
medical equipment and other goods involved in COVID-19 response
efforts;
(2) supporting COVID-19 testing and surveillance
activities;
(3) providing nutritional assistance to vulnerable
populations; and
(4) carrying out other disaster preparedness and response
functions for other emergencies and natural disasters.
(c) Requirement.--As soon as practicable, the Administrator of the
Federal Emergency Management Agency shall make public job announcements
to fill the CORE employee positions authorized under subsection (a),
which shall prioritize hiring from among the following groups of
individuals:
(1) Unemployed veterans of the Armed Forces.
(2) Individuals who have become unemployed or underemployed
as a result of the coronavirus public health emergency.
(3) AmeriCorps members, Peace Corps Volunteers, or United
States Fulbright Scholars who have had their service terms
ended as a result of the coronavirus public health emergency.
(4) Recent graduates of public health, medical, nursing,
social work or related health-services programs.
(5) Members of communities who have experienced a
disproportionately high number of COVID-19 cases.
(d) Hiring.--The Federal Emergency Management Agency shall hire
employees under this section, pursuant to section 306 of the Robert T.
Stafford Disaster Relief and Emergency Assistance Act (42 U.S.C. 5149),
and make use of existing statutory authorities that permit regional
offices and site managers to advertise for and hire such employees.
(e) Training.--The Administrator of the Federal Emergency
Management Agency may make appropriate adjustments to the standard
training course curriculum for employees under this section to include
on-site trainings at Federal Emergency Management Agency regional
offices, virtual trainings, or trainings conducted by other Federal,
State, local or Tribal agencies, including training described in
section 2(d)(4).
(f) Clarification.--For the purposes of employing individuals under
this section--
(1) no individual who is authorized to work in the United
States, including individuals with Deferred Action for
Childhood Arrivals (DACA) or Temporary Protected Status (TPS)
under section 244 of the Immigration and Nationality Act (8
U.S.C. 1254a), shall be disqualified for appointment under this
section because of citizenship or immigration status; and
(2) no individual shall be disqualified for appointment
under this section because of bankruptcy or a poor credit
rating determined to be the result of the Coronavirus public
health emergency.
(g) Authorization of Appropriations.--There are authorized to be
appropriated to the Administrator of the Federal Emergency Management
Agency, $6,500,000,000, for each of fiscal years 2020 through 2022, not
less than $1,500,000,000 of which shall be made available each such
fiscal year for the administrative costs associated with carrying out
this section.
<all>
Health Force and Resilience Force Act of 2020
#3606 | S Congress #116
Policy Area: Health
Subjects: BankruptcyCardiovascular and respiratory healthCenters for Disease Control and Prevention (CDC)Child healthCommunity life and organizationCongressional oversightConsumer creditDepartment of Health and Human ServicesDepartment of Homeland SecurityDisaster relief and insuranceEmergency medical services and trauma careEmployee hiringEmployment and training programsExecutive agency funding and structureFederal Emergency Management Agency (FEMA)Federal-Indian relationsFood assistance and reliefForeign laborGovernment employee pay, benefits, personnel management
Last Action: Read twice and referred to the Committee on Health, Education, Labor, and Pensions. (5/5/2020)
Bill Text Source: Congress.gov
Summary and Impacts
Original Text